Guaifenesin, Pseudoephedrine, and Codeine
Pronunciation
(gwye FEN e sin, soo doe e FED rin, & KOE deen)
U.S. Brand Names
Cheratussin DAC; Codafed® Expectorant; Codafed® Pediatric Expectorant; Guiatuss™ DAC®; Mytussin® DAC; Nucofed® Expectorant; Nucofed® Pediatric Expectorant; Nucotuss® [DSC]
Synonyms
Codeine, Guaifenesin, and Pseudoephedrine; Pseudoephedrine, Guaifenesin, and Codeine
Generic Available
Yes
Canadian Brand Names
Benylin® 3.3 mg-D-E; Calmylin with Codeine
Use
Temporarily relieves nasal congestion and controls cough due to minor throat and bronchial irritation; helps loosen phlegm and thin bronchial secretions to make coughs more productive
Restrictions
C-III; C-V
Pregnancy Risk Factor
C
Lactation
Excretion in breast milk unknown/use caution
Adverse Reactions
See individual agents.
Drug Interactions
See individual agents.
Pharmacodynamics/Kinetics
See individual agents.
Dosage
Oral:
Children 6-12 years: 5 mL every 4 hours, not to exceed 40 mL/24 hours
Children >12 years and Adults: 10 mL every 4 hours, not to exceed 40 mL/24 hours
Patient Education
See individual agents.
Pregnancy/breast-feeding precautions:
Inform prescriber if you are or intend to become pregnant. Consult prescriber if breast-feeding.
Dental Health: Effects on Dental Treatment
Key adverse event(s) related to dental treatment:
Codeine: Xerostomia (normal salivary flow resumes upon discontinuation).
Guaifenesin: No significant effects or complications reported
Pseudoephedrine: Xerostomia (normal salivary flow resumes upon discontinuation).
Dental Health: Vasoconstrictor/Local Anesthetic Precautions
Use with caution since pseudoephedrine is a sympathomimetic amine which could interact with epinephrine to cause a pressor response
Mental Health: Effects on Mental Status
Guaifenesin may cause drowsiness or dizziness; pseudoephedrine may cause anxiety or restlessness; codeine may cause drowsiness; may cause euphoria, confusion, insomnia, hallucinations, or depression
Mental Health: Effects on Psychiatric Treatment
Concurrent use with psychotropics may produce additive sedation or lessen the effects of anxiolytics depending on whether the effects of guaifenesin/codeine or pseudoephedrine predominate; concurrent use with MAO inhibitors may result in hypertensive crisis; avoid combination
Dosage Forms
[DSC] = Discontinued product
Liquid (Cheratussin DAC): Guaifenesin 100 mg, pseudoephedrine hydrochloride 30 mg, and codeine phosphate 10 mg per 5 mL (480 mL) [sugar free]
Syrup:
Codafed® Expectorant: Guaifenesin 200 mg, pseudoephedrine hydrochloride 60 mg, and codeine phosphate 20 mg per 5 mL (480 mL) [wintergreen flavor]
Codafed® Pediatric Expectorant: Guaifenesin 100 mg, pseudoephedrine hydrochloride 30 mg, and codeine phosphate 10 mg per 5 mL (480 mL) [strawberry flavor]
Guiatuss™ DAC: Guaifenesin 100 mg, pseudoephedrine hydrochloride 30 mg, and codeine phosphate 10 mg per 5 mL (480 mL)
Mytussin® DAC: Guaifenesin 100 mg, pseudoephedrine hydrochloride 30 mg, and codeine phosphate 10 mg per 5 mL (120 mL, 480 mL) [sugar free; contains alcohol 1.7%; strawberry-raspberry flavor]
Nucofed® Expectorant, Nucotuss® Expectorant [DSC]: Guaifenesin 200 mg, pseudoephedrine hydrochloride 60 mg, and codeine phosphate 20 mg per 5 mL (480 mL) [contains alcohol 12.5%; cherry flavor]
Nucofed® Pediatric Expectorant: Guaifenesin 100 mg, pseudoephedrine hydrochloride 30 mg, and codeine phosphate 10 mg per 5 mL (480 mL) [contains alcohol 6%; strawberry flavor]
International Brand Names
Benylin® 3.3 mg-D-E (CA); Calmylin with Codeine (CA)
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